Christus Trinity Clinic Holly Lake | |
5321 S Fm 14 Hawkins TX 75765-4839 | |
(903) 769-2990 | |
Not Available |
Full Name | Christus Trinity Clinic Holly Lake |
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Speciality | Clinic/Center |
Location | 5321 S Fm 14, Hawkins, Texas |
Authorized Official Name and Position | John Christopher Glenney (VP) |
Authorized Official Contact | 9036064445 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Christus Trinity Clinic Holly Lake Po Box 846098 Dallas TX 75284-6098 Ph: (903) 324-6400 | Christus Trinity Clinic Holly Lake 5321 S Fm 14 Hawkins TX 75765-4839 Ph: (903) 769-2990 |
NPI Number | 1396939146 |
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Provider Enumeration Date | 09/04/2007 |
Last Update Date | 01/10/2020 |
Medicare PECOS PAC ID | 3072426741 |
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Medicare Enrollment ID | O20050328000327 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396939146 | NPI | - | NPPES |
179427301 | Medicaid | TX | |
143621 | Other | TX | SUPERIOR HEALTH |
673886 | Other | TX | MEDICARE PART A |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |